Sunday, July 06, 2008

Why Is Getting Medical Care Down Here Such a Battle?

It’s happened again -- I have an infection and I can’t get treatment!

The lab culture results came back positive on June 11 -- as in almost a month ago. And these results show that I don’t have just any old everyday infection -- this one is only susceptible to IV or injected antibiotics. Great.

The results were faxed by the lap to my doctor. When I didn’t hear from him 10 days later, I personally faxed the results to the doctor and requested on the cover sheet that he call me. Not response still. So I called the doctor’s office and left a message asking him to call me. Nada. I refax the results with another request to contact me. Nothing. Another call, another message, and then another. Still nothing.

Finally, on June 30, the doctor FINALLY calls me and asks me what’s up. I tell him that I h]ave an infection that will only respond to IV antibiotics. He is annoyed when I cannot tell him -- off the top of my head at 7:30 am -- what specific drugs it will respond to. He orders me to call him back in an hour to read him to drug responsiveness list. Of course when I call, he is unavailable.

When he finally calls me back two hours later and I read the list of drugs to me (he still can’t find any of the THREE copies that had already been faxed to him), he tells me that they are all IV drugs. Excuse me? Didn’t I just tell you that the first time you called??

So then he tells me that I have to go in the hospital. I tell him no, I am not going to do that for the following reasons:

  • It is unnecessary because there is a home health care agency on island who can do the IV therapy in my house. Why should I take up a hospital bed (which are always filled) for something that can be done just as well in the comfort of my own home?
  • I cannot afford to go in the hospital. (Medicare would bill be a $1000 copay plus 20 percent of the balance due.) It would be cheaper for everyone involved for me to be treated at home.
  • The hospital cannot provide me with the daily meds I take. They make me bring my own, then try to take them from me so they can give them to me when they feel like it.
  • The hospital does not have a shower bench for their accessible shower. I would have to bring my own bench from home or go without showering for the entire time I am in there. Who go through all that humiliation when I have an accessible shower at my house?
  • There is only one accessible bathroom I can use in the hospital. It is located in the x-ray department, two floors below the patient rooms. I have to ask permission to leave the floor to go use it. Again, accessible bathroom at home that I can use whenever I feel like it.

After heaving a deep, resentful sigh, he tells me that I MUST go in the hospital because he doesn’t like the home agency. I tell him I do like them, and trust them, and have references to back me up, and then ask him to write the orders. He tries again to tell me no, but I hold firm. Finally he succumbs -- or so I think -- and tells me to have the home agency contact him for orders. As I thank him, he blurts out, “No, this is wrong” but then sighs, tells me to AGAIN fax him a copy of the oab results and repeats that I should have the home health people call him.

Thinking I am finally going to get some treatment started, three weeks after a diagnosis was made, I call the home health agency. The owner there informs me that it is against Medicare rules for them to contact a doctor asking for orders for someone -- doing so is considered solicitation of business and strictly forbidden. The owner was familiar with my doctor (and agreed with me that he is passive-aggressive and difficult to work with), and confirmed that the doctor KNEW that it was illegal for them to call him on my behalf,

At this point I am angry and frustrated as all get out. In a final attempt to get this doctor to help me, I fax him a fourth copy of the lab results with a cover page that thanks him for his cooperation and asks him to contact me when a referral for home health care was ready to be picked up. What a shock -- I haven’t heard from him since (the fax was sent last Tuesday).

So tomorrow I start the hunt for a new doctor. I have been rejected my doctors on this island before for being too complicated, and I just dread the thought of having to go through another fight just to get a doctor, and then perhaps even more battles to get them to prescribe the home-based IV therapy I need.

I cannot believe that getting a doctor to cure an infection through] the most cost-effective and logical means possible is so frickin’ hard. What is WRONG with this island???

Should anyone wonder why we’re leaving Paradise as soon as we can get out of here, refer them to this blog entry.